SU1425543A1 - Method of predicting relapse of ulcer after vagotomy - Google Patents

Abstract

The invention relates to medicine, more specifically to methods for diagnosing "diseases of the digestive organs, intended to predict the relapse of ulcers after vagotomy without antrumectomy. The purpose of the invention is to increase the accuracy of the method. For this, the pH of the source is introduced into the patient on an empty stomach into the stomach. Under the control of fluoroscopy, antral and corpuscular electrodes are installed in the corresponding parts of the stomach, the pH probe is connected to a pH-340 pH meter. The readings of both sensors are recorded every 5-10 minutes for 40-60 minutes. The minimum pH values of both electrodes are selected, the difference between them is calculated. With a minimum pH of the body electrode below 1.0 or with a cross section of the minimum pH of the body electrode below 1.8 and the difference between the minimum pH of the body and antral electrodes less than 0.5, relapse is predicted. 1 tab. § (L s

Description

4U

he ate

The invention relates to madaschine, and in particular to methods of diagnosing diseases of the digestive organs, and vagotomy without

-increase is used for relapse of ulcers after antrumectomy.

The goal of not comprehending the way.

The method is carried out as follows jg.

In the morning on an empty stomach, a p, H probe of the Frisin Scientific Research Institute of Current is introduced into the patient's stomach. Under the control of fluoroscopy, antral and corpus electrodes are installed in the corresponding stomach sections and the pH probe is connected to a pH 340 pH meter. Both sensors are recorded every 5-10 minutes for 40-60 min. The pH of the electrodes calculates the difference between these indicators and the pH of the body electrode is below 1–8 and the difference between 25 meters per day pH of the body and electrode electrodes is less than predicted by relapse.

Example 1, Patient G. 49 lats POSTUPIL; after 4 months. After a selective proximal vagotomy, a patient with duodenal ulcer disease complicated by gastrointestinal bleeding was admitted to the hospital for examination. 35 In the morning, the pH probe of the French Research Institute He-Antral and corpuscular electrodes were installed in the stomach of the patient. under the control of x-40 genoscopy, the pH probe is connected to the pH-340 device and every 5 minutes for 40 minutes the pH of both electrodes was recorded, the pH of the body electrode was of the highest value; 45 1.2; 0.8; 1.4; 1.0; 0.8 | 1.2; 1.0 | 0.8 pH antral electrode 1.3; 1.8; B0 | 1.2; 0.9 | four; 1.2; 0.9. The difference between now is calculated, - pH antral to body-gg o sensors: 0.1; tpO; 05.4; 0.2; 0.1; 0.2; 0.2; 0.1, Therefore, the minimum pH of the body sensor is 0.8, the minimum difference between the pH of the neutral and body sensors is .55 0.1. Based on the pH of the housing datac below 1.0 (Oe8) and the minimum a.dnitsa meladu the pH of the antral and corus electrodes is less than 0, 5 (O ;;)

despite the well-being, the patient suspected relapse ulcers. By an objective method of gastroduodenal fibroscopy, this diagnosis was confirmed on the anterior and posterior walls of the pylorus, two lesions with a diameter of 0.6 and 0.4 cm were found.

Therefore, in this case, the proposed method made it possible to predict the presence of ulcer recurrence even in the absence of clinical symptoms of the disease.

Example 2, Ill., 29 years old, was admitted to hospital for examination after 2 months. after stem vagotomy, excision of the bleeding duodenal ulcer and Heineck e-Mikulich pyloroplasty, taken in connection with complicated duodenal ulcer disease. The patient's condition was satisfactory. According to the preformed method, in the morning on an empty stomach, the patient was given a pH-metri using pH-zones, a ca and a pH-340 apparatus every 10 minutes for 60 minutes. The pH of the body and antral electrodes were recorded. The minimum indicators of the pH of the body electrode were 152, the minimum difference between the pH of the antral and body electrodes is 0. Moreover, the pH of the body electrode is periodically reached, n 2p85, which indicates duodenogastric reflux. On the basis of the low pH of the corpus electrode (below 1j8-t52) and the combination with the pH difference between the corpus and antral electrodes less than 0.5, the patient made an unfavorable prognosis - relapse of the ulcer disease, which was confirmed by objective endoscopic and radiological methods after 7 months, after surgery - The spinal cord of the duodenum was 0.3 cm in diameter. These methods of investigation were undertaken in connection with the reopening of the clinical symptoms of duodenal ulcer in the patient.

Therefore, in this case, it was possible to proactively develop clinical symptomatology using the prodlogeck method, to predict the recurrence of duodenal ulcer disease after the stem vaginal otomy with the presence of duodeno-angular reflgox.

PRI me R 3. Observations of changes in the pH of the corpus and antral electrodes in a patient, G, who underwent vagotomy without antrumpectomy for duodenal ulcer disease (observation every 7 min for 50 min

As can be seen from a comparison of specific examples of observations during relapse of the ulcer, the minimum case of the corpus electrode took place up to 1.0, while in the absence of recurrence of the ulcer in another patient, the minimum pH of the corpus electrode was 1.8 when combined with the difference of minima The pH of the antral and case electrodes is more than 0.5.

Consequently, with indicators exceeding the selected optimal for predicting relapse of ulcers after vagotomy without antrumitomy, the ear does not recur.

The proposed method has been applied in 184 patients of the clinical hospital of emergency medical care, suffering from ulcer disease and undergoing various types of vagotomy. 60 of them (32.6% of patients;) suffered from duodenogastral reflux. On the basis of the developed criteria, 57 patients made a prognosis about the occurrence of recurrent ulcers, which was confirmed using objective methods of gastro-duodenofibroscopy and fluoroscopy of the gastrointestinal tract in 52 of them (92.9%). In these patients, the minimum pH of the body electrode was 0.8 + 0.1,, 001 in 7 patients, the minimum pH value of the body electrode was 1.1 to 1.8, combined with the difference between the body and antral electrodes equal to or mena { 1st 0.5.

When comparing the results obtained using the proposed and known methods, it turned out that in 60 patients from 18D (with duodenogastric reflux) the proposed method works, while

0 by a known method could not be reproduced due to the admixture of bile in the gastric juice, masking the change in color reactions to sialic acids and protein. Consequently, ..

5 the proposed method has greater accuracy in comparison with the known method. The prognosis for the proposed method was justified in 92.9% of patients, in a known manner - in 68%.

0 In addition, the proposed method is less time consuming compared to the known one: the research using the proposed method takes 40-60 minutes, while the known method takes 2.5-3 hours.

Claims (1)

 Invention Formula A method for predicting the recurrence of ulcers after vagotomy by examining the contents of the patient's stomach, characterized in that, in order to improve the accuracy of the method, a pH probe is installed on an empty stomach patient, antral and corpuscular electrodes are installed, and their readings are recorded every 5-10 minutes for 40 minutes. -60 min, and with a minimum pH value of the body electrode below 1.0 or a combination of the minimum pH value of the body electrode below 40 1.8 and the difference between the minimum pH values of corpus and antral electrodes less than 0.5 predict recurrence of ulcers. 0 3S Sick pH of the body electrode elek Result of endoscopy of the upper gastrointestinal tract that